目的：评价食管心房调搏前肌内注射胃复安注射液对电极安放耗时和安全性的影响。方法选择2012年2月至2013年5于泸州市中医医院心血管内科门诊行食管心房调搏检查的患者80例，依据计算机软件编制随机分配表将患者分为试验组42例和对照组38例，两组均于食管心房调搏前肌内注射药物1 mL（试验组为胃复安注射液1 mL／10 mg，对照组为0．9％氯化钠注射液1 mL，两组均为无色透明液体），观察经鼻食管电极安放平均耗时及安全性（误吸及恶心呕吐）。结果试验组电极安放平均耗时较对照组显著缩短，差异有统计学意义（P ＜0．05）；试验组患者0例出现误吸，对照组患者1例，差异无统计学意义（P＞0．05）；恶心呕吐评级比较，试验组安全性优于对照组（P＜0．05）。结论在食管心房调搏前肌注胃复安注射液能明显缩短电极安放耗时，提高电极安放的安全性，减轻患者痛苦。

Objective To evaluate the time-consuming and safety of TEAP of anterior intramuscular in-jection of metoclopramide.Methods In 80 cases of patients were randomly divided into experimental group and control group.For two groups of patients were in the esophagus electrode placed before intramuscular drug 1ml (experimental group for metoclopramide injection 1 mL/10 mg,control group 1 mL 0.9% sodium chloride injection),observation of nasal esophagus electrode placed average time and safety.Results The experimental group of electrodes placed average time was significantly shorter than the control group , there was statistically significant difference between the two groups(P 0.05).Comparison of nausea and vomiting in the test group security rat-ing, better than the control group(P<0.05).Conclusion This study confirmed in esophageal pacing of in-tramuscular injection of metoclopramide injection ( metoclopramide) significantly shortened electrodes placed time-consuming,enhances the e

目的：探讨食管心房调搏(TEAP)对折返性室上性心动过速的定位诊断价值。方法：对24例经食管心房调搏术诱发室上性心动过速患者的心电图进行旁路或房室结双径路、多径路的定位判断，并将其结果与心内电生理检查结果进行对比分析。结果：经TEAP对SVT的诊断符合率91.7%。其中TEAP对S-F型DAVNP的敏感性88.2%，特异性100%；对隐匿性旁路的敏感性100%，特异性89.5%；对左侧显性旁路及右侧显性旁路的敏感性100%，特异性100%。结论：TEAP对折返性室上性心动过速的定位有较好的临床诊断价值，尤其是对显性旁路，可在此基础上拟定射频消融的治疗方案。

Objective:To investigate the localization diagnosis value of transesophageal atrial pacing(TEAP) on reentrant supraventricular tachycardia beckoning.Methods:24 patients with transesophageal atrial pacing induced supraventricular beckoning had ECG speed were positioning bypass or dual atrioventricular nodal pathways,multi route judgment,and we compared the results with intracardiac electrophysiological examination results.Results:The diagnosis coincidence rate of TEAP for SVT was 91.7% .The sensitivity of TEAP for S-F type DAVNP was 88.2% ,and the specificity was 100% ;the sensitivity for concealed accessory pathway was 100%,and the specificity was 89.5%;the sensitivity for left and right dominant bypass was 100%,and the specificity was 100% .Conclusion:TEAP is valuable in clinical diagnosis for better reentrant supraventricular tachycardia positioning,especially for the dominant bypass.We can make radiofrequency ablation treatment based on it.

心房起搏时，因心房波振幅低、双腔心脏起搏器起搏房室（AV）间期设置较短或心房除极延迟等原因，体表心电图不易判断心房夺获情况，此时，可依据心腔内心电图、食管心电图及超声心动图对心房夺获情况进行判断。

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目的：探讨高频超声在新生儿食管闭锁合并气管食管瘘诊断中的应用价值。方法应用 PhilipsIU22三维容积高频线阵探头,频率为5~12MHz,对18例(男10例,女8例)疑为食管闭锁气管食管瘘新生儿术前行胸部正侧位、插胃管及高频超声食管纵行扫描,观察食管闭锁超声图像表现,测量食管近远端盲端间距离,并与手术测量结果统计对照分析。结果所有患儿均获得满意的食管近远端超声图像：食管结构呈外低内高回声环,闭锁食管的上下段盲端显示清楚；上端食管盲端的位置与主动脉弓关系密切,下端食管沿左心房后方向近端延伸；所有患儿均可在同一屏幕内直接测量食管上下盲袋间的距离0.1~3.5 cm,术中测量距离为0.1~3.6 cm,两者对应差值小于0.2 cm,R =0.99,P <0.01。结论高频超声检查能够清晰显示闭锁食管上下盲端的位置、管径的大小及合并气管食管瘘情况,可以准确测量上下盲端的距离。超声检查实时性、可重复性及无创性对先天性食管闭锁气管食管瘘诊断、治疗具有广阔的临床应用前景。

Objective To evaluate the accuracy of preoperative ultrasonography (US) in depicting the structure of esophageal atresia with tracheoesophageal fistula (EA-TEF)and determine its role in planning surgical strategy by digitally measuring interpouch distance (ID).Methods A total of 1 8 neonates (10 males,8 females)with congenital EA-TEF were recruited.After obtaining chest radiographs with a coiled nasogastric tube in upper esophageal pouch,longitudinal esophageal high-frequency US was performed.The esophageal structures were displayed and the IDs measured on US images were compared with the surgical findings.The esophageal structures were displayed,and the IDs measured on US images were compared with the surgical findings.Results With the use of US, the structure of EA-TEF was accurately depicted.And the IDs detected by US correlated well with the surgical findings.Statistical analysis demonstrated no significant difference in the IDs as assessed by US and surgery (0.1-3.5 vs 0.1-3.6 cm)

目的探讨多普勒超声能否有效地预测阵发性心房颤动(PAF)患者的左心房压力(LAP)。方法选择PAF患者31例,导管射频消融术前1d行经胸及经食管彩色多普勒超声检查,测左心房内径、LVEF、舒张期肺静脉血流衰减时间(DTD)、收缩期肺静脉血流衰减时间(STD)等相关参数;术中通过心导管测量LAP。对多普勒超声参数与LAP进行相关性分析。结果 31例患者LAP(14.45±7.60)mm Hg(1mm Hg=0.133kPa)、DTD(176.97±56.74)ms、STD(193.97±55.17)ms。DTD和STD与LAP呈负相关(r=-0.63,r=-0.81,P=0.00)。结论DTD和STD可能是简便、可靠、无创性预测PAF患者LAP的理想指标。

Objective To study whether Doppler echocardiography can effectively predict the left atrial pressure (LAP) in paroxysmal atrial fibrillation (PAF) patients .Methods Thirty-one PAF patients underwent transthoracic and transesophageal echocardiography 1 day before radiofre-quency ablation .Deceleration time of pulmonary venous diastolic flow (DTD )and deceleration time of pulmonary venous systolic flow (STD ) were measured .Relation between Doppler echocardio-graphy parameters and LAP was analyzed .Results The LAP was 14 .45 ± 7 .60 mm Hg (1 mm Hg=0 .133 kPa) ,the DTD was 176 .97 ± 56 .74 ms ,the STD was 193 .97 ± 55 .17 ms .The DTD and STD were closely related with the LAP (r= -0 .63 ,r= -0 .81 ,P=0 .00) .Conclusion DTD and STD can accurately and noninvasively predict the LAP in PAF patients .